This invention relates generally to the fields of biochemistry and medicine. More particularly, the present invention relates to methods and substances for use in accelerating the growth or healing of tissue.
Wounds (i.e., lacerations or openings) in mammalian tissue result in tissue disruption and coagulation of the microvasculature at the wound face. Repair of such tissue represents an orderly, controlled cellular response to injury. All soft tissue wounds, regardless of size, heal in a similar manner. Tissue growth and repair are biologic systems wherein cellular proliferation and angiogenesis occur in the presence of an oxygen gradient. The sequential morphological and structural changes which occur during tissue repair have been characterized in great detail and have in some instances been quantified [Hunt, T. K. et al., xe2x80x9cCoagulation and macrophage stimulation of angiogenesis and wound healing,xe2x80x9d in The surgical wound, pp. 1-18, ed. F. Dineen and G. Hildrick-Smith (Lea and Febiger, Philadelphia: 1981)].
The cellular morphology consists of three distinct zones. The central avascular wound space is oxygen deficient, acidotic and hypercarbic, and has high lactate levels. Adjacent to the wound space is a gradient zone of local anemia (ischemia) which is populated by dividing fibroblasts. Behind the leading zone is an area of active collagen synthesis characterized by mature fibroblasts and numerous newly-formed capillaries (i.e., neovascularization). While this new blood vessel growth (angiogenesis) is necessary for the healing of wound tissue, angiogenic agents are in general unable to fulfill the long-felt need of providing the additional biosynthetic effects of tissue repair. Despite the need for more rapid healing of wounds (i.e., severe burns, surgical incisions, lacerations and other trauma), to date there has been only limited success in accelerating wound healing with pharmacological agents.
U.S. Pat. No. 5,015,629 to DiZerega (the entire disclosure of which is hereby incorporated by reference) describes a method for increasing the rate of healing of wound tissue, comprising the application to such tissue of angiotensin II (AII) in an amount which is sufficient for said increase. The application of angiotensin II to wound tissue significantly increases the rate of wound healing, leading to a more rapid re-epithelialization and tissue repair. The term angiotensin II refers to an octapeptide present in humans and other species having the sequence Asp-Arg-Val-Tyr-Ile-His-Pro-Phe [SEQ ID NO:1]. Angiotensin II is a known pressor agent and is commercially available.
Despite the utility of angiotensin II in accelerating wound healing, there remains a need for additional agents which are useful in promoting wound healing. Moreover, it would be highly advantageous to employ an agent which is less potent than angiotensin II at inducing hypertension.
PCT Patent Applications PCT/US94/10502 and PCT/US94/10503 disclose the use in wound repair of compositions comprising angiotensin II analogs and angiotensin III and analogs thereof, respectively. While these compositions have clear utility in wound treatment, there remains a need for compositions and methods with which fewer undesired side-effects may be associated.
A peptide agonist selective for the AT2 receptor (the peptide has 1000xc3x97 higher affinity for AT2 than AT1) has been identified. This peptide is p-aminophenylalanine6-AII [xe2x80x9c(p-NH2-Phe)6-Allxe2x80x9d], Asp-Arg-Val-Tyr-Ile-Xaa-Pro-Phe [SEQ ID NO:2] wherein Xaa is p-NH2-Phe [Speth, R C and K H Kim. 1990. Discrimination of two angiotensin II receptor subtypes with a selective agonist analogue of angiotensin II, p-aminophenylalanine6 angiotensin II. Biochem Biophys Res Commun 169:997-1006]. This peptide gave binding characteristics comparable to the AT2 antagonists in the experimental models tested [Catalioto et al. 1994. Angiotensins induce the release of prostacyclin from rabbit vas deferens: evidence for receptor heterogeneity. Eur J Pharmacol 256:93-97; Bryson, S E et al. 1992. Induction of the angiotensin At2 receptor subtype expression by differentiation of the neuroblastoma x glioma hybrid, NG-108-15. Eur J Pharmacol 225:119-127].
It is an object of the present invention to provide compositions and methods which do not suffer from all of the drawbacks of the heretofore-known compositions.
The present invention relates to the use of angiotensin II Type 2 receptor agonists (xe2x80x9cAT2 agonistxe2x80x9d) in wound healing. These compounds form the basis of compositions useful for accelerating wound healing, the compositions comprising at least one AT2 agonist in an amount effective to accelerate wound healing. Agonists of the AT2 receptor subtype are of benefit in wound repair but do not exhibit many of the side effects of angiotensin II, such as increases in blood pressure and thirst. Preferably, the compositions are in the form of matrical or micellar solutions.